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What are Environmental Allergies?

Allergies are an inappropriate immune response to a benign substance and affect an estimated 20% of the world’s population (Dougherty, 2023).

This reaction can be life-threatening if not treated quickly and appropriately, which is called anaphylactic shock. The substances that trigger allergies, called allergens, range from tree pollen to food to medical products.

Environmental allergies describe any allergies that are triggered by environmental allergens, which can be found both inside and outside of a home. It is the most common type of allergy and can be further divided into two types: seasonal allergies, which happen during specific seasons, and perennial allergies, which happen all year round.

The length of the allergic reaction differs from one person to another and is linked to the severity of the allergy. It may appear within minutes of exposure or take a few hours. A person may be allergic to a single allergen or multiple ones, and they may be genetic or develop after an initial exposure.

Manage your allergy today.

Living with allergies can seem like a never-ending battle, but you do not have to fight alone. At Wilderman Medical Clinic, our solutions offer a comprehensive approach to your treatment.

How do Environmental Allergies Work?

The allergic reaction is caused by a hypersensitive immune system that sees benign environmental allergens as a threat to the body (Dougherty, 2023). Once such an allergen comes into contact with the body, it triggers a cascade of biological immune responses similar to those found in bacterial and viral infections.

This cascade happens as follows:

  1. The body comes into contact with an environmental allergen. This exposure can happen by touching and/or inhaling it. The first exposure may not cause an allergic reaction but rather prime the body to react to a subsequent exposure.
  2. This allergen binds to antigens on specific white blood cells, the B cell lymphocytes, and T helper cells, which results in the formation of allergen-specific immunoglobulin E (IgE) antibodies.
  3. IgE attaches itself to the surface of basophils and eosinophils, in the blood, and mast cells, in tissues. If this is the first exposure to the allergen, these IgE prime the body to have an allergic reaction on the second exposure.
  4. When an allergic reaction is initiated, the allergens activate the allergen-specific IgE and cause the granulation, or destruction of the cellular membrane, of the basophil, eosinophil, and mast cells.
  5. Histamine, the main chemical responsible for an allergic reaction, is released as a result of the granulation along with other biochemicals and hormones involved in inflammation, vasodilation (widening of blood vessels), and bronchoconstriction (constriction of the airways).
  6. The flood of biochemicals and hormones leads to the typical symptoms of an allergic reaction. It may affect several areas of the body, including the eyes, nose, skin, and lungs.

Risk Factors

Some factors may increase your risk of having environmental allergies (Aldakheel, 2021).

These factors are:

  • Having close family members with environmental allergies. If both of your parents have environmental allergies, your risk of having it is 60-80%. If only one parent has it, it drops to 30-50%.
  • Having high levels of IgE. This is the current theory on the prevalence of environmental allergies in people of African descent.
  • The levels of testosterone and estrogen in your body. Bouman et al. (2005) have shown that testosterone reduces the production of antibodies while estrogen increases it. This may explain why women/AFAB and estrogen-sensitive individuals are more likely to have or develop allergies. However, in children, boys/AMAB have a higher risk of developing environmental allergies. The exact reason for this is still under investigation. The current theory is that the higher IgE present in boys/AMABs may predispose them to developing allergies before puberty increases their testosterone levels.
  • Age: Children, pre-puberty, are more likely to have environmental allergies than adults.
  • Exposure to smoke, whether from cigarettes, cigars, or fire.
  • Chronic exposure to high levels of airborne particulate matter (dust, smog, soot, dirt, chemicals), nitrogen dioxide, and ozone.
  • Gastrointestinal disorders: The gut plays an important role in the autoimmune response. As such, if the gastrointestinal system does not function properly, it increases the risk of developing environmental allergies.

Symptoms

The symptoms associated with environmental allergies are:

  • Sneezing
  • Runny nose
  • Congested nose and/or chest
  • Itching/irritation/rash around the point of contact or face
  • Eye-watering/irritation
  • Trouble breathing: shortness of breath, wheezing, coughing fits, asthma exacerbation
  • Fatigue
  • Headaches

Some people compare their symptoms to those of a cold. Not everyone may exhibit the same symptoms or intensity.

Please be aware that in children, toddlers, and newborns, these symptoms may not be easy to spot and may be accompanied by:

  • Crying,
  • Increased irritability
  • Reduced sleep
  • Trouble focusing
  • Repetitive rubbing around the nose and eyes
  • Ear pressure/pain/infections
  • Upset stomach/Gastrointestinal issues

If you have any or a combination of the following symptoms, please call 911 or have someone bring you to the nearest emergency department:

  • Shortness of breath/difficulty breathing
  • Excessive swelling of the lips, mouth, nose, or eyes
  • Sudden difficulty swallowing/talking clearly
  • Feeling faint or exhausted
  • Sudden redness/heat over your arms, face, and legs
  • Nausea/vomiting
  • Dizzy/vertigo spell with no known cause
  • Hearing your pulse in your ears
  • Rapid and weak heart rate/pulse
  • Pins & needles/tingling sensation in your hands, feet, or scalp

These are signs of a dangerous allergic reaction that require immediate medical care. If you have a prescribed emergency medication, take it immediately as you wait for the ambulance or to be driven to the emergency clinic.

Common Environmental Allergic Triggers

Environmental allergens are (Institute for Quality and Efficiency in Health Care & InformedHealth.org, 2020):

  • Pollen: Any type of pollen, whether from flowers or trees, may be an allergen.
  • Grass: Cut grass releases chemicals into the air, which can cause an allergic reaction.
  • Dust mites: While the dust mites themselves are harmless, their byproducts and corpses can be inhaled and create allergies.
  • Mold
  • Animal dander or saliva: This includes fur, scales, hair, and other body parts that shed over time. In most cases, the actual allergen is a protein secreted by the animal and transferred elsewhere.
  • Insect stings
  • Air particles such as smoke, dust, and dirt. All of these can cause irritation when inhaled and lead to an allergic reaction.
  • Strong smells: Some individuals are sensitive to smells and end up with an allergy to them. In others, the cause of their allergic reaction is due to the irritation these smells can cause.
  • Chemicals: Certain chemicals can have strong and irritating smells or airborne particles.
  • Sun/UV light: Whether due to genetics or medication, some people are hypersensitive to the effects of UV-based light on their skin.

Diagnosis

To verify if you have environmental allergies, and if so to what, your doctor/medical team will ask for:

  • Your and your family’s medical history
  • Symptoms and any patterns you may have noticed
  • Whether over-the-counter allergy medication has improved the symptoms

To confirm the presence of an environmental allergy, you will be referred to an allergist, who will confirm the above information before proceeding to test you for specific allergens.

There are a few different types of allergy tests:

  1. Patch test: This allows us to verify the presence of contact dermatitis and what allergens may trigger it. A variety of allergens are placed on the skin and left there for 48 hours, after which the skin is checked for an allergic reaction. A secondary check is performed another 48 hours after that to check for delayed or false-positive reactions.
  2. Skin prick test: This is the most common allergy test used to verify various types of allergies. This test consists of putting a small amount of allergen on the skin and then creating a small cut to allow the allergen to enter the body. This allows the allergist to identify the exact allergens and the intensity of the allergic reaction in a safe environment.
  3. Blood tests: Verifying the IgE levels in the blood when exposed to specific allergens may help identify environmental allergies. This test is indicated if a skin prick test or patch test is contraindicated or unavailable.
  4. Challenge test: If other tests do not show an allergic reaction, or if the allergens are unavailable to be used as part of the test, then it is possible to recreate the circumstances of an environmental allergic reaction using the suspected allergen. This test must be done under direct clinical supervision.

Treatments

The specific treatment offered to a person will depend on the allergen(s), severity of the reaction, age, and availability of the treatments (Dougherty, 2023).

These treatments are:

  1. Medications: Antihistamine medication can be found over the counter in most pharmacies. Your medical team may suggest decongestants and corticosteroids to treat specific environmental allergy symptoms.
  2. Prevention: Preventing your exposure to your specific allergens is often the first treatment provided. This may not be feasible in all cases and should be adjusted to your situation.
  3. Immunotherapy: Also known as allergy shots, this treatment involves introducing a small amount of your allergens into your body over several years until your body no longer recognizes the substances as allergens. This treatment must be tailored to your specific allergens and sensitivities. The average length of this treatment is around 5 years of weekly (first year) or monthly (consecutive years) injections.
  4. Emergency rescue medication: If your allergic reaction is severe and/or dangerous, your medical team will likely recommend that you start carrying rescue medication. The most common type is an epinephrine injector (EpiPen) but it may also include bronchodilators to prevent asphyxiation. This treatment will be part of a larger treatment plan.

Prevention

The first treatment is reducing your exposure to your allergens as much as possible. Depending on the type of environmental allergens and the intensity of the reaction, some prevention tips may not apply to you.

The bedroom is one of the most used rooms in a house. As such, it is important to limit allergen exposure while you sleep. To do this:

  1. Reduce the presence of dust mites: Dust mites are often found on your bed, pillows, and fabrics such as carpets and blankets. To reduce their presence, regularly clean your fabrics and use allergen covers, and bags used to limit transfer between yourself and the bed/pillows.
  2. Reduce animal dander or saliva in your bedroom: This could mean preventing a pet from entering or sleeping in your room, and/or keeping any animal-exposed clothing outside of the bedroom.

Here are some tips for general prevention:

  1. Regularly clean your home to prevent allergen buildup.
  2. Keep your windows closed between 2 and 9 pm. This is the time when pollen counts are the highest.
  3. Avoid going outside when there is a high pollen count. If you need to go outside, then ensure that you wear a mask, wear clothes that protect your skin, and put on sunscreen.
  4. Reduce the presence of carpets or hard-to-clean fabrics in your house.
  5. Limit the amount of water and/or food left exposed. This will reduce the chances of mold growth and insects being drawn into your home.
  6. Replace cleaning products with scentless versions where possible.
  7. Improve indoor ventilation by using fans or by installing a good air circulation system.
  8. Clean air ducts once a year or as needed/possible.
  9. Regularly replace air filters in air circulation systems.
  10. Use air filters inside: Air filters can help reduce airborne allergens that regular cleaning may miss. HEPA-level filters are suggested where possible; however, you can make your own DIY air filter with similar results (Eykelbosh, 2023).
  11. Adopt healthy hygiene and eating habits.

Wilderman Medical Clinic

The Wilderman Medical Clinic has an on-site allergy clinic that can provide you with testing for your environmental allergies.

Reference

Aldakheel, F. M. (2021). Allergic Diseases: A Comprehensive Review on Risk Factors, Immunological Mechanisms, Link with COVID-19, Potential Treatments, and Role of Allergen Bioinformatics. International Journal of Environmental Research and Public Health, 18(22), 12105. https://doi.org/10.3390/ijerph182212105

Bouman, A., Heineman, M. J., & Faas, M. M. (2005). Sex hormones and the immune response in humans. Human Reproduction Update, 11(4), 411–423. https://doi.org/10.1093/humupd/dmi008

Dougherty, J. M. (2023, February 8). Allergy. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK545237/

Eykelbosh, A. (2023, January 18). Do-it-yourself (DIY) air cleaners: Evidence on effectiveness and considerations for safe operation | National Collaborating Centre for Environmental Health | NCCEH – CCSNE. National Collaborating Center for Environmental Health. https://ncceh.ca/documents/evidence-review/do-it-yourself-diy-air-cleaners-evidence-effectiveness-and-considerations
Institute for Quality and Efficiency in Health Care & InformedHealth.org. (2020, April 23). Allergies: Overview. National Library of Health. https://www.ncbi.nlm.nih.gov/books/NBK447112/

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